中华流行病学杂志
中華流行病學雜誌
중화류행병학잡지
CHINESE JOURNAL OF EPIDEMIOLOGY
2010年
8期
841-844
,共4页
王增武%陈祚%王芳%郑润平%朱曼璐%王淑玉%王益新%陆菊明%王海燕%刘力生
王增武%陳祚%王芳%鄭潤平%硃曼璐%王淑玉%王益新%陸菊明%王海燕%劉力生
왕증무%진조%왕방%정윤평%주만로%왕숙옥%왕익신%륙국명%왕해연%류력생
肾功能%心血管事件%中老年人群
腎功能%心血管事件%中老年人群
신공능%심혈관사건%중노년인군
Kidney function%Cardiovascular events%Middle-to-old-aged population
目的 了解肾功能下降与心血管事件是否有独立的关联关系.方法 2004年在北京市首钢社区随机抽取40岁及以上人群2500人,实际调查2315人.收集清晨首次尿标本,测量尿白蛋白和肌酐;采静脉血标本,测量血肌酐;使用简化的MDRD公式估计肾小球滤过率(eGFR),同时调查心血管病危险因素.随后对上述调查人群随访4年,记录心血管事件.根据eGFR值[ml/(min·1.73m2)]将人群分为3组,＜60、60～90、＞90.使用Cox回归模型调整混杂因素,分析慢性肾脏病与心血管事件及总事件的关联.结果 2315人中,肾功能下降(eGFR＜60)的患病率为3.3%.三组人群心血管事件发生率分别为43.9/1000人年、21.8/1000人年和11.5/1000人年,总事件发生率分别为53.7/1000人年、28.8/1000人年和14.6/1000人年.调整混杂因素后,与eGFR＞90组相比,60≤eGFR＜90组和eGFR＜60组心血管事件发生的风险(95%CI)分别为1.29(0.85～1.96)和2.14(1.02～4.50);总事件发生的风险分别为1.25(0.86～1.81)和1.95(1.00～3.80).结论 肾功能下降与心血管事件及总事件独立相关.
目的 瞭解腎功能下降與心血管事件是否有獨立的關聯關繫.方法 2004年在北京市首鋼社區隨機抽取40歲及以上人群2500人,實際調查2315人.收集清晨首次尿標本,測量尿白蛋白和肌酐;採靜脈血標本,測量血肌酐;使用簡化的MDRD公式估計腎小毬濾過率(eGFR),同時調查心血管病危險因素.隨後對上述調查人群隨訪4年,記錄心血管事件.根據eGFR值[ml/(min·1.73m2)]將人群分為3組,＜60、60～90、＞90.使用Cox迴歸模型調整混雜因素,分析慢性腎髒病與心血管事件及總事件的關聯.結果 2315人中,腎功能下降(eGFR＜60)的患病率為3.3%.三組人群心血管事件髮生率分彆為43.9/1000人年、21.8/1000人年和11.5/1000人年,總事件髮生率分彆為53.7/1000人年、28.8/1000人年和14.6/1000人年.調整混雜因素後,與eGFR＞90組相比,60≤eGFR＜90組和eGFR＜60組心血管事件髮生的風險(95%CI)分彆為1.29(0.85～1.96)和2.14(1.02～4.50);總事件髮生的風險分彆為1.25(0.86～1.81)和1.95(1.00～3.80).結論 腎功能下降與心血管事件及總事件獨立相關.
목적 료해신공능하강여심혈관사건시부유독립적관련관계.방법 2004년재북경시수강사구수궤추취40세급이상인군2500인,실제조사2315인.수집청신수차뇨표본,측량뇨백단백화기항;채정맥혈표본,측량혈기항;사용간화적MDRD공식고계신소구려과솔(eGFR),동시조사심혈관병위험인소.수후대상술조사인군수방4년,기록심혈관사건.근거eGFR치[ml/(min·1.73m2)]장인군분위3조,＜60、60～90、＞90.사용Cox회귀모형조정혼잡인소,분석만성신장병여심혈관사건급총사건적관련.결과 2315인중,신공능하강(eGFR＜60)적환병솔위3.3%.삼조인군심혈관사건발생솔분별위43.9/1000인년、21.8/1000인년화11.5/1000인년,총사건발생솔분별위53.7/1000인년、28.8/1000인년화14.6/1000인년.조정혼잡인소후,여eGFR＞90조상비,60≤eGFR＜90조화eGFR＜60조심혈관사건발생적풍험(95%CI)분별위1.29(0.85～1.96)화2.14(1.02～4.50);총사건발생적풍험분별위1.25(0.86～1.81)화1.95(1.00～3.80).결론 신공능하강여심혈관사건급총사건독립상관.
Objective This study aimed to determine the relationships between estimated glomerular filtration rate (eGFR) and cardiovascular events. Methods 2500 residents aged more than 40 years old were selected from Shougang community, Shijingshan district, in Beijing. 2315 of them took part in the survey. First morning urinary sample was collected for all the participants.Albumin and creatinine were measured and eGFR was calculated using simplified MDAD formula.Cardiovascular risk factors were also investigated. The participants were followed up for 4 years, and all-cause mortality and cardiovascular events were collected. The subjects were divided into three groups according to eGFR[ml/(min·1.73 m2)]: ＜60, 60-90,＞90.Cox regression model was used to analyze the relationships between eGFR, all events, and cardiovascular events after adjusting for confounders. Results The prevalence of eGFR ＜60 was 3.3%. The incidence rates of cardiovascular events were 43.9, 21.8 and 11.5/1000 person-years among three groups, and the incidence rates of all events (all-cause mortality and cardiovascular events) were 53.7, 28.8 and 14.6/1000 person-years,respectively. After adjusting for age, gender, smoking, body mass index, serum lipids, diabetes mellitus, cardiovascular disease, the hazard risk (HR) for cardiovascular events was 1.29 (95%CI:0.85-1.96) in eGFR＜60 group and 2.14 (95% CI: 1.02-4.50) in 60≤eGFR＜90 group, when compared with the eGFR＞90 group; the HR for all events were 1.25 (95%CI: 0.86-1.81 ) and 1.95(95% CI: 1.00-3.80) , respectively. Conclusion In the population studied, eGFR＜60 seemed an independent predictor for cardiovascular events and all-cause events.
